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Marshall James Nev, PLC | Diet and Pain in Richmond

Lexington-Richmond Headache Clinic
Marshall James Ney, DMD, FAAOP
Fellow American Academy of Oral Facial Pain

527 W. Main St.
Richmond, 40475
(859) 623-3761

Diet and Pain

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How much does diet relate to pain? We don't really know, but we do know that there is a connection.

Experts still don't agree on protiens' anti-inflammatory effects, carbohydrates' inflammatory effects, or that to loose weight you should eat small meals 6 times per day. So enjoy the read. Some of the following is a summary of an article in the Practical Pain Management journal.

Also included are opinions on nutrition and pain of Dr. Janice Blythe PhD, the chair of the department of nutrition at Berea College, a nationally ranked small liberal arts college in Berea, Kentucky.

Finally, I have asked my personal trainer for her opinion on diet and muscle building by increasing weight, decreasing fat, and increasing muscle mass.

Let’s see what I can tell you on the latest information on Diet & Pain. Since I had a headache for 7 years, I do have a little insight, but please remember that much of the information here is anecdotal and not evidence based.

It's About Protein

Most pain patients crave carbohydrates and sugar, which is precisely the opposite of what they need. Carbohydrates cause inflammation of the muscles and joints whereas proteins have anti-inflammatory effects.

Chronic pain has a significant effect on a patient's hormone/nutritional system. Chronic pain creates an unstable level of a hormone called cortisol. Excess carbohydrates also cause unstable levels of cortisol and sugar, and are inflamatory to the muscles. This causes a state where muscle is wasted, diminished mental capacity exists, and patients feel general weakness when they are in pain.

With the addition of significant protein ingestion, many of these symptoms may disappear.

As you may recall, the solution to headache and neck pain has several parts. How you eat is part of the solution. The Lexington Headache Clinic is successful because we address these multiple parts.

We also listen very carefully to you, the patient. In real estate the three must haves are location, location, location. In medicine, it is history, history, history. And only you, the patient, can provide us the history.

The fundamental principal of the chronic pain diet is to have a diet high in protein that avoids carbohydrates and refined sugars. This is because carbohydrates inflame muscle tissue and refined sugars have a tendency to cause hypoglycemia (low blood sugar) weight gain.

The high protein diet is also intended to promote strength, movement, energy and mental function. The dietary supplements are intended to assist in the regeneration of tissue, muscle pain and prevent osteopenia and osteoporosis. Diets high in Carbohydrates and sugars can cause hypoglycemia (low blood sugars), which can result in an increase of pain. (I have personally had this happen). Friday afternoon, no patients scheduled, do I have a real lunch with protein… no, I have some sweet carbohydrates from the break room table…what happens later with a carb/sugar meal on the run…you guessed it shoulders tighten up, pressure builds in the temple, hunger has not been satisfied and I go for more carbs….You asked for it Jim, and you are solely responsible for your headache, and this time it is not a sleep or bite problem, IT IS STRICTLY A DIET PROBLEM! Congratulations Doc!

So, let’s load up on protein, reduce our carbs and sugar intake. Absolutely no sugar drinks, including fruit juices, and if you are overweight, no milk. (I am glad I am not over weight because I love milk!)

Many chronic pain patients have low Vitamin D levels. Vitamin D is not really a vitamin; it is actually a hormone with receptors in 5 or 6 areas of the brain which are areas responsible for monitoring pain.

If D2 is low we need to write an Rx for 50,000 units of vitamin D by prescription. If vitamin D3 is low an over the counter vitamin D is available with 5,000 units.

Other nutrition that needs to be taken besides vitamins are:

  • Essential Fatty Acids have a very potent anti-inflammatory effect. You can get them in the Omega 3 fish oil available in the vitamin section. Look for the DHA and EPA acronymns. If you want to lower your cholesterol, 500mg of Niacin and the Omega 3 fish oil have been shown to help.
  • Zinc is also good because it can help control sugar or glucose levels. Take about 10-20 mg. per day. Remember, Zinc is also the magic in Zicam which can boost the body’s immune system and help fight off colds if taken early enough.
  • Magnesium Levels (within the cell) are typically low in headache patients. If they are low, then a supplement of 400 to 500 mg of magnesium per day is recommended. If you are taking a multi-vitamin, be sure to check that it contains Zinc and Magnesium (not manganese).
  • Protein supplement is probably the most important supplement. It contains Whey Protein Supplement which includes the 8 essential amino acids (proteins) that we must eat because our body cannot manufacture them. No one knows exactly how much protein we need, but a good guess is the Whey protein Supplement available at Wal-Mart for about $15.00 for a one month’s supply is definitely a great start. I actually use two containers/month. This because I drink it after I exercise and as an afternoon snack. I mix mine in a blender in the morning and in a shake jar with a metal ball and ice in the afternoon. It includes proteiIsoleucine, leucine, lysine, methionine, phenylalanine, and threonine. Tryptophan (remember the 4 and under pain relief recipe) and valine plus 10 other non essential proteins.
  • Amnino Acids (proteins) enter the blood stream from the intestines and travel to locations in the liver, different glands (thyroid, adrenal, pituitary, etc) and brain where they are the building blocks for compounds critical for pain relief. These compounds include endorphins which the natural occurring opioid that the body makes when you exercise, and dopamine, serotonin, insulin, and thyroid hormones.

Ok, what else do proteins do?

  1. Build muscle and cartilage.
  2. Protein causes the liver to produce a hormone called glucagon. Glucagon is the only hormone that blocks glucose (sugar) from being stored as fat. (Remember, carbohydrates are actually complex sugars.) This means if you drink a soft drink with sugar and no protein, the sugar will be stored as ugly fat!
  3. Proteins are very powerful ant-inflammatory agents.
  4. High cholesterol, lipids (fat) and glucose (sugar) are common to chronic pain. Good pain control stabilizes sugar levels and lipid (fat) levels.
  5. It is well known that caffeine raises Dopamine levels in the brain and this helps with the pain. Caffeine also constricts the swollen arteries of a migraine. However, caffeine also has a half-life of about 5-7 hours, so you should not use any caffeine within 7 hours of bed time.

I hope this gives you some insight on the relationship between diet and pain. There are many different theories concerning diet and pain. So don’t be surprised if some doctors tell you differently. Most doctors, will not have an opinion beyond a multi vitamin. Don’t let this discourage you. Most medical schools do not give a comprehensive course on diet and nutrition. Once again, because there is no incentive (money) to study diet and pain. These are only the opinions of doctors. However they do practice pain medicine and will anecdotaly know what seems to work In their practice.

Diet for People With Chronic Headaches

  1. Eat one or more of these protein foods every time you eat. Beef, fish, seafood, poultry, eggs, cottage cheese, pork or lamb.
  2. Eat a green vegetable daily. Spinach, green beans broccoli, peas, Lettuce, celery, okra or bean sprouts.
  3. Limit the following: rolls, donuts, bread, pastries, potatoes, rice, pasta, tortillas. NEVER EAT ANY OF THESE WITHOUT EATING PROTEIN WITH THEM!
  4. Salt: do not use!
  5. Drink non carbohydrate drinks, Drink tea or coffee with low calorie sugar substitutes. Diet drinks are acceptable.
  6. Do not drink the following: Fruit juice, regular sugar sodas, coffee or tea with regular sugar, energy drinks that contain carbohydrates
  7. Milk: Do not drink milk if you are overweight.
  8. Caffeine: Okay, but without sugar or artificial cream. A sugar substitute is okay. I personally have my coffee with Splenda and skim milk.

Dietary Substitutes:

  1. Take one complete dietary supplement (multi-vitamin) every day. Any brand is fine as long as it has folic acid and/or vitamin C.
  2. Take one or two calcium, vitamin groups together and you get agreement.
  3. Take a vitamin B-12 tablet under your under tongue 3 times per week.
  4. There is some evidence that Omega 3 fish oil and Niacin will lower your cholesterol as much as Lipitor.
  5. Don’t forget the protein supplement. This is very important!

A message from Angela Barnhill, my personal trainer

As a Personal Trainer and Pro Fitness Athlete for over 20 years and a mother of 3 and grandmother of 3, the problem that 90% of my clients and the general population has with not getting the results they want from their fitness routine is their diet. Doing their cardiovascular training and weight training may be a challenge at first but then as they get into the habit of working out, it becomes something that can be scheduled in without too much of a problem (30-60 minutes per day). A healthy diet, however, seems to be much harder to fit into one's lifestyle. Why is this?

I believe that it is because our culture does not support eating healthy or good nutrition. Just look at the choices you are faced with on a daily basis: fast food, huge portions, and dessert on every corner! There is also so much bad information out there about how we need to eat to be healthy and fit: “don’t eat carbohydrates,” “don’t eat dairy,” eat only “grapefruit,” “starve yourself!” It can be so confusing. I would like to share with you just a few tips and information that fitness athletes such as body builders, and figure professionals have known for years. We know how to get the body fat off while keeping our hard-earned fat burning muscle and look lean, fit, and strong.

The 7 most important new habits you can incorporate into your lifestyle are these:

  1. Do your cardiovascular training first thing in the morning on an empty stomach for 20-30 minutes. This will jump start your metabolism for the day and since your stomach is empty the first fuel source your body is burning is FAT!
  2. Keep your sugar intake to no more than 25 grams per day. Sugar will age you before your time! Keep it low.
  3. Drink at least 90 oz. of pure water per day. As we age we lose our natural thirst, causing our body to hold onto water and not burn fat as efficiently.
  4. Cut back on carbohydrates towards the end of the day. Eat complex carbohydrates early in the day when you need energy. Stop eating carbohydrates after 2pm (fruits, rice, potatoes,pasta). Focus on lean protein and vegetables after 2pm.
  5. Eat “Clean” 90% of the time. Eat whole foods (foods that you find around the perimeter of the grocery store such as low fat dairy, meats, fresh vegetables, fruits, and nuts.
  6. Stop eating 2-3 hours before you go to bed. Your metabolism begins to slow down around 4pm to prepare for the night ahead when your body will be fasting. Whatever you eat before bed, you will be taking to bed with you and you won't be hungry in the morning and ready to eat b-r-e-a-k-f-a-st- the most important metabolism starting meal of the day.
  7. One meal per week, eat whatever it is you want or crave. This is your “cheat” meal and will give your mind and body a break from routine and actually increase your metabolism and prevent you from feeling deprived and later binging on the “forbidden” food.

What do you have to lose? Try these tips and see what happens. If you need more information feel free to contact me at 859-523-2378 or [email protected]
Angela Barnhill
Owner- Personal Best
Fitness/ Personal Training Studio


Richmond Dentist | Diet and Pain. Marshall James Ney is a Richmond Dentist.